868 BAY ESPLANADE FEDERAL EMERGENCY MANAGEMENT AGENCY O.M.B. No. 3067-0077
NATIONAL FLOOD INSURANCE PROGRAM Expires July 31, 2002
ELEVATION CERTIFICATE
Im ortant: Read the instructions on a es 1 -7.
�� SECTION A-PROPERTY OWNER INFORMATION For Insurance Company Use: :
�.DING OWNER'S NAME Policy Number
- E o 3�KC�
BUILDING STREET ADDRESS(Including Apt.,Unit,Suite,andlor Bldg.No.)OR P.O.ROUTE AND BOX NO. Company NAIC Number
81of3 ES !,A�1 -
cir�rcr.EAIL ATE2 EA�-1 sT � ziPCO`3�
� � .
PRO ERTY DESCRIPTION(Lot and BI ck rumbers, ax Parcel Nu ber,Legal Description,etc.)
� �/Z � ��"S 1 � 4� B I.oGK �I A MANDA LA y
BWLDING USE(e.g.,Residential,Non-residential,Addition,Accessory,etc. U e Comments sedion if necessary.)
RE.s��E�T�a��
LATITUDE/LONGITUDE(OPTIONAL) HORIZONTAL DATUM: SOURCE: U GPS(Type):
( ##°-##'-##.##" or ##.##K##' U NAD 1927 �NAD 1983 (_�USGS Quad Map U Other:
SECTION B-FLOOD INSURANCE RATE MAP(FIRM)INFORMATION
81.NFIP COMMUNITY NAME 8 COMMUNITY NUMBER B2.COUNTY NAME B3.STATE
G�T o G.EARWATER 1Z5o9� �fNELl.�4S l.�
B4.MAP AND PANEL 85.SUFFIX 66.FIRM INDEX B7.FIRM PANEL 68.FLOOD B9.BASE FLOOD ELEVATION(S)
NUMBER DATE EFFECTNFJREVISED DAl'E Z NE(S) (Zone AO,use depth of flooding)
�2Sa9t� 0007 D g_��-92 �-19- 9 � /�►E. �o.o
610. Indicate the sourc.e of the Base Flood Elevation(BFE)data or base flood depth entered in B9.
�FIS Profile �FIRM U Community Determined U Other(Describe):
611. Indicate the elevation datum used for the BFE in B9:�NGVD 1929 U NAVD 1988 U Other(Describe):
612. Is the building located in a Coastal Barrier Resources System(CBRS)area or Othervvise Rrotected Area(OPA)? U Yes 1�'No
Designation Date:
SECTION C-BUILDING ELEVATION INFORMATION(SURVEY REGIUIRED)
'+.Buiiding elevations are based on: uConstruction Drawings" UBuilding Under Construction" inished Construction
'A new Elevation Certificate will be required when construction of the building is complete.
�, . Building Diagram Number 8 (Select the building diagram most similar to the buitding for which this certificate is being completed-see
pages 6 and 7. If no diagram accurately represents the building,provide a sketch or photograph.)
C3. Elevations—Zones A1-A30,AE,AH,A(with BFE),VE,V1-V30,V(with BFE),AR,AR/A,AR/AE,AR/A1-A30,AR/AH,AR/AO
Complete Items C3a-i below according to the building diagram specified in Item C2.State the datum used.If the datum is different from
the datum used for the BFE in Section B,convert the datum to that used for the BFE.Show fieid measurements and datum conversion
calculation. Use the space provided or the Comments area of Section D or Section G,as appropriate,to document the datum conversion.
Datum Conversion/Comments
Elevation reference mark used �T�� ��� • Does the elevation reference mark used appear on the FIRM? �Yes ��No
0 a)Top of bottom floor(induding basement or enclosure) �•7� _ft.(m) m
0 b)Top of next higher floor 7•o •_ft•(m) `� f 511II j�D. '1•y 37
❑ c)Bottom of lowest horizontal structural member(V zones only) N�._ft.(m) ��
❑ d)Attached garage(top of slab) N/� _ft.(m) W g �����/�.,�
❑ e)Lowest elevation of machinery and/or equipment -,; � �J
servicing the building �•? _ft.(m) E; 2' •00
❑ �Lowest adjacent grade(LAG) �7.Z _ft.(m) z'N
D g)Highest adjacent grade(HAG) S.Z . ft.(m) �
0 h)No.of permanent openings(flood vents)within 1 ft.above adjacent grade� �
❑ i)Total area of all permanent openings(flood vents)in C3h 1�$2 sq.in.(sq.cm)
SECTION D-SURVEYOR,ENGINEER,OR ARCHITECT CERTIFICATION
This certification is to be signed and sealed by a land surveyo�,engineer,or architect authorized by law to certify elevation information.
1 certify thaf the infom►ation in Sections A, B,and C on this ce�ti(�cate nspresents my best efl`orts to interpret the data availab/e.
1 understand that any fa/se sfatement may be punishable by�ine orimprisonment under 18 U.S. Code, Section 1001.
CERT�FI�f3�N�1ME, �vA�S LICENS�t�l�(1A�ER
L,AeK Y L vf3
TTLE �RVEyO� EVANS �/J�OMP/�xF�ll�� �'��/ ING.
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�JDRES CITY STA ZIP C q
� 6EL 6ES S , �. 9 DuN ED I N � 3�� g
SIGNATUR DATE T� P � „ B L
.
FEMA Form 81 31,A 9 SEE REVERSE SIDE FOR CONTINUATION REPLACES ALL PREVIOUS EDITIONS